Spend more time with patients. Less time on billing.

HMO receivables are the whole problem

Patient payments settle immediately. HMO claims settle in weeks or months, are frequently paid short, and are occasionally rejected for reasons that surface long after the treatment. A practice that treats a submitted claim as money in the bank is planning against a figure that has not been agreed.

What makes the difference is unremarkable: knowing which claims are outstanding, how old each one is, and which were paid at less than the amount submitted. Ageing is the number that gets HMOs to pay, because a specific overdue list is answerable and a general complaint is not.

Two payers, two workflows

• Private patients: paid at the point of care, receipted immediately, and reconciled the same day.
• HMO and corporate: submitted as a claim, chased on a schedule, part-paid, and reconciled against a remittance advice that rarely matches the submission line for line.

Recording both against the same patient record is what makes the practice legible: the same person may be private for one visit and covered for the next.

VAT and medical services

Medical and pharmaceutical products are zero-rated, and most medical services are exempt. The distinction matters: on a zero-rated supply you can still reclaim input VAT on your costs; on an exempt supply you cannot.

A practice that also sells non-medical goods, or provides services that fall outside the exemption, is operating across more than one treatment and should have that confirmed rather than assumed. Getting it wrong in either direction is expensive.